REPORT OF A CASEA 32-year-old woman presented with a slowly enlarging, slightly tender mass over a 4-month period involving her left earlobe. Her ears were pierced at age 7 years and remained patent without complications. One month before the current problem, an earring fragmented in the left ear and could not be completely dislodged. Chronic irritation persisted, and, subsequently, a rapidly growing, slightly painful tumor evolved. She denied any other medical problems.Physical examination showed a disk-shaped, well-circumscribed lesion (2.5×2.5×0.7 cm) encompassing the entire left ear lobe (Figure 1). The surface revealed pink, firm, gritty tissue with slightly indurated borders. The center of the disk had a small punctum, probably a remnant of the earring hole. Regional lymph nodes were not enlarged on palpation.An incisional wedge biopsy specimen was obtained, and the histologic diagnosis of probable invasive squamous cell carcinoma to all margins was made (Figure 2). Surgical